Mutagens produced by the pyrolysis of opium and its alkaloids as possible risk factors in cancer of the bladder and oesophagus

Malaveille, Christian; Friesen, Marlin D.; Camus, Anne-Marie; Garren, Liliane; Hautefeuille, A.; Béréziat, Jean‐Claude; Ghadirian, P; Day, Nicholas E.; Bartsch, Helmut

doi:10.1093/carcin/3.5.577

Cited by 56 publications

(36 citation statements)

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“…The consumption of opium, and in particular of opium dross (shireh and sukhteh), has been suspected to be a major aetiological factor for ESCC in Golestan Province (Joint Iran-IARC Study Group, 1977;Hewer et al, 1978;Malaveille et al, 1982;Dowlatshahi and Miller, 1985;Ghadirian et al, 1985). One-third (33%) of ESCC patients in our study had ever used opium, and similar proportions of opium usage were seen in the other patients.…”

Section: Discussionsupporting

confidence: 65%

Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

et al. 2004

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Previous studies have shown that oesophageal and gastric cancers are the most common causes of cancer death in the Golestan Province, Iran. In 2001, we established Atrak Clinic, a referral clinic for gastrointestinal (GI) diseases in Gonbad, the major city of eastern Golestan, which has permitted, for the first time in this region, endoscopic localisation and histologic examination of upper GI cancers. Among the initial 682 patients seen at Atrak Clinic, 370 were confirmed histologically to have cancer, including 223 (60%) oesophageal squamous cell cancers (ESCC), 22 (6%) oesophageal adenocarcinomas (EAC), 58 (16%) gastric cardia adenocarcinomas (GCA), and 58 (16%) gastric noncardia adenocarcinomas. The proportional occurrence of these four main site-cell type subdivisions of upper GI cancers in Golestan is similar to that seen in Linxian, China, another area of high ESCC incidence, and is markedly different from the current proportions in many Western countries. Questioning of patients about exposure to some known and suspected risk factors for squamous cell oesophageal cancer confirmed a negligible history of consumption of alcohol, little use of cigarettes or nass (tobacco, lime and ash), and a low intake of opium, suggesting that the high rates of ESCC seen in northeastern Iran must have other important risk factors that remain speculative or unknown. Further studies are needed to define more precisely the patterns of upper GI cancer incidence, to test other previously suspected risk factors, and to find new significant risk factors in this high-risk area.

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Section: Discussionsupporting

confidence: 65%

Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

et al. 2004

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“…The high incidence of some other malignancies in Iran, such as esophageal cancer in north-easterner provinces (Nasrollahzadeh et al, 2008) and laryngeal cancer (Mousavi et al, 2003) has also been linked to opium consumption. Different mechanisms have been proposed for this carcinogenicity and mutagenicity such as pyrolysis of opium (Malaveille et al, 1982).…”

Section: Discussionmentioning

confidence: 99%

Age at Diagnosis in Bladder Cancer: Does Opium Addiction Play a Role?

Karbakhsh

Dabbagh²,

Shabani³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Bladder cancer is a major health problem, especially among men. Opium addiction can be an important risk factor. One important question is whether it can affect the age of onset of bladder cancer .We performed this study to evaluate this question. Materials and Methods: In a cross-section study, records of patients diagnosed with bladder carcinoma in Shahid Labbafinejad Medical Center, within 1999-2008 were included. Data were extracted from records regarding age at onset, gender, smoking status, and opioid addiction and analyzed with SPSS 13. Results: Within 10 years, 920 cases were diagnosed with bladder cancer of which 97 percent were transitional cell carcinoma. In 698 cases, opium addiction status was recorded in 21.3% (n=149). Age at diagnosis was 59.7±11.51 (median: 60) among opioid addicts which was significantly lower than nonaddicts (63.1±13.65, Median: 65) (P<0.001). Conclusions: Opium addiction can decrease the age of onset of bladder cancer.

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“…However, either smoking or inhaling the smoke involves exposure to potential carcinogens, including polycyclic aromatic hydrocarbons (PAHs) to which industrial exposure may cause cancers of the lung, bladder, and skin (Denissenko et al, 1996;Boffetta et al, 1997;Hecht, 2003). Smoke condensates from opium and morphine cause mutations in Salmonella typhimurium (Hewer et al, 1978;Malaveille et al, 1982), sister chromatid exchanges in human lymphocytes (Perry et al, 1983), and morphological transformations in cultured Syrian hamster embryo cells (Friesen et al, 1985), whereas crude opium itself is not a mutagen (Hewer et al, 1978;Malaveille et al, 1982). The mechanisms responsible for the carcinogenic effects of opium and shireh need investigation.…”

Section: Discussionmentioning

confidence: 99%

Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran

et al. 2008

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The very high incidence of oesophageal squamous cell carcinoma (ESCC) in Golestan Province in northeastern Iran was suggested by studies in the 1970s as partly due to opium use, which is not uncommon in this area, but based on limited numbers. From December 2003 to June 2007, we administered a validated structured questionnaire to 300 ESCC cases and 571 controls, matched on neighbourhood of residence, age (±2 years), and sex. We used conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for potential confounders. Compared with those who used neither tobacco nor opium, risk of ESCC was increased in those who used tobacco only (OR, 95% CI: 1.70, 1.05 -2.73), in those who used opium only (2.12, 1.21 -3.74), and in those who used both tobacco and opium (2.35, 1.50 -3.67). All forms of tobacco use (cigarettes, hookah, and nass) were associated with higher ESCC risk. Similarly, use of both crude opium and other forms of opium were associated with higher risk. Alcohol consumption was seen in only 2% of the cases and 2% of the controls, and was not associated with ESCC risk.

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Mutagens produced by the pyrolysis of opium and its alkaloids as possible risk factors in cancer of the bladder and oesophagus

Cited by 56 publications

References 0 publications

Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

Age at Diagnosis in Bladder Cancer: Does Opium Addiction Play a Role?

Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran

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